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Chapter 21 - Treating the violent patient with psychosis or impulsivity utilizing antipsychotic polypharmacy and high-dose monotherapy

from Section 5 - Psychopharmacology

Published online by Cambridge University Press:  19 October 2021

Katherine D. Warburton
Affiliation:
University of California, Davis
Stephen M. Stahl
Affiliation:
University of California, San Diego
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Publisher: Cambridge University Press
Print publication year: 2016

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References

Stahl, SM, Morrissette, DA, Citrome, L, et al. “Meta-guidelines” for the management of patients with schizophrenia. CNS Spectr. 2013; 18(3): 150162.Google Scholar
Stahl, SM. Emerging guidelines for the use of antipsychotic polypharmacy. Rev. Psiquiatr. Salud Ment. 2013; 6(3): 97100.Google Scholar
Citrome, L, Volavka, J. Pharmacological management of acute and persistent aggression in forensic psychiatry settings. CNS Drugs. 2011; 25(12): 10091021.Google Scholar
Warburton, K. The new mission of forensic mental health systems: managing violence as a medical syndrome in an environment that balances treatment and safety. CNS Spectr. 2014; 0(5): 368373.CrossRefGoogle Scholar
Nolan, KA, Czobor, P, Roy, BB, et al. Characteristics of assaultive behavior among psychiatric inpatients. Psychiatr. Serv. 2003; 54(7): 10121016.Google Scholar
Volavka, J, Citrome, L. Heterogeneity of violence in schizophrenia and implications for long-term treatment. Int. J. Clin. Pract. 2008; 62 (8): 12371245.Google Scholar
Volavka, J, Citrome, L. Pathways to aggression in schizophrenia affect results of treatment. Schizophr. Bull. 2011; 37(5): 921929.Google Scholar
Swanson, JW, Swartz, MS, Van Dorn, RA, et al. Comparison of antipsychotic medication effects on reducing violence in people with schizophrenia. Br. J. Psychiatry. 2008; 193(1): 3743.Google Scholar
Quanbeck, CD, McDermott, BE, Lam, J, et al. Categorization of aggressive acts committed by chronically assaultive state hospital patients. Psychiatr. Serv. 2007; 58(4): 521528.Google Scholar
Stahl, SM. Stahl's Essential Psychopharmacology, 4th edn. New York: Cambridge University Press; 2013.Google Scholar
Stahl, SM, Morrissette, DA. Stahl's Illustrated Violence: Neural Circuits, Genetics, and Treatment. New York: Cambridge University Press; 2014.Google Scholar
Siever, LJ. Neurobiology of aggression and violence. Am. J. Psychiatry. 2008; 165(4): 429442.Google Scholar
Frogley, C, Taylor, D, Dickens, G, Picchioni, M. A systematic review of the evidence of clozapine's anti-aggressive effects. Int. J. Neuropsychopharmacol. 2012; 15(9): 13511371.CrossRefGoogle ScholarPubMed
Coccaro, EF, McCloskey, MS, Fitzgerald, DA, Phan, KL. Amygdala and orbitofrontal reactivity to social threat in individuals with impulsive aggression. Biol. Psychiatry. 2007; 62(2): 168178.Google Scholar
Coccaro, EF, Sripada, CS, Yanowitch, RN, Phan, KL. Corticolimbic function in impulsive aggressive behavior. Biol. Psychiatry. 2011; 69(12): 11531159.Google Scholar
Bobes, J, Fillat, O, Arango, C. Violence among schizophrenia out-patients compliant with medication: prevalence and associated factors. Acta Psychiatr. Scand. 2009; 119(3): 218225.CrossRefGoogle ScholarPubMed
Meyer, J. A rational approach to employing high plasma levels of antipsychotics for violence associated with schizophrenia: case vignettes. CNS Spectr. 2014; 19(5): 432438. DOI: http://dx.doi.org/10.1017/ S1092852914000236.Google Scholar
Stahl, SM. Antipsychotic polypharmacy: never say never, but never say always. Acta Psychiatr. Scand. 2012; 125(5): 349351.Google Scholar
Pavlov, KA, Chistiakov, DA, Chekhonin, VP. Genetic determinants of aggression and impulsivity in humans. J. Appl. Genet. 2012; 53(1): 6182.Google Scholar
Fazel, S, Grann M, Langstrom N. What is the role of epidemiology for forensic psychiatry? Crim. Behav. Ment. Health. 2009; 19(5): 281285.CrossRefGoogle ScholarPubMed
Fazel, S, Gulati, G, Linsell, L, Geddes, JR, Grann, M. Schizophrenia and violence: systematic review and meta-analysis. PLoS Med. 2009; 6 (8): e1000120.Google Scholar
Fazel, S, Langstrom, N, Hjern, A, Grann, M, Lichtenstein, P. Schizophrenia, substance abuse, and violent crime. JAMA. 2009; 301(19): 20162023.Google Scholar
Topiwala, A, Fazel, S. The pharmacological management of violence in schizophrenia: a structured review. Expert Rev. Neurother. 2011; 11(1): 5363.CrossRefGoogle ScholarPubMed
Krakowski, MI, Czobor, P. Executive function predicts response to antiaggression treatment in schizophrenia: a randomized controlled trial. J. Clin. Psychiatry. 2012; 73(1): 7480.CrossRefGoogle ScholarPubMed
Krakowski, MI, Czobor, P, Nolan, KA. Atypical antipsychotics, neurocognitive deficits, and aggression in schizophrenic patients. J. Clin. Psychopharmacol. 2008; 28(5): 485493.Google Scholar
Singh, JP, Grann, M, Fazel, S. A comparative study of violence risk assessment tools: a systematic review and metaregression analysis of 68 studies involving 25,980 participants. Clin. Psychol. Rev. 2011; 31(3): 499513.Google Scholar
Song, H, Min, SK. Aggressive behavior model in schizophrenic patients. Psychiatry Res. 2009; 167(1–2): 5865.Google Scholar
Uchida, H, Takeuchi, H, Graff-Guerrero, A, et al. Dopamine D2 receptor occupancy and clinical effects: a systematic review and pooled analysis. J. Clin. Psychopharmacol. 2011; 31(4): 497502.Google Scholar
Correll, CU. From receptor pharmacology to improved outcomes: individualising the selection, dosing, and switching of antipsychotics. Eur. Psychiatry. 2010; 25(Suppl 2): S12S21.Google Scholar
Nord, M, Farde, L. Antipsychotic occupancy of dopamine receptors in schizophrenia. CNS Neurosci. Ther. 2011; 17(2): 97103.Google Scholar
Uchida, H, Takeuchi, H, Graff-Guerrero, A, et al. Predicting dopamine D receptor occupancy from plasma levels of antipsychotic drugs: a systematic review and pooled analysis. J. Clin. Psychopharmacol. 2011; 31(3): 318325.Google Scholar
Stauffer, V, Case, M, Kollack-Walker, S, et al. Trajectories of response to treatment with atypical antipsychotic medication in patients with schizophrenia pooled from 6 double-blind, randomized clinical trials. Schizophr. Res. 2011; 130(1–3): 1119.Google Scholar
Robinson, DG, Woerner, MG, Alvir, JM, et al. Predictors of treatment response from a first episode of schizophrenia or schizoaffective disorder. Am. J. Psychiatry. 1999; 156(4): 544549.Google Scholar
Stahl, SM. Stahl's Essential Psychopharmacology, 3rd edn. New York: Cambridge University Press; 2008.Google Scholar
Morrissette, DA, Stahl, SM. Optimizing outcomes in schizophrenia: long-acting depots and long-term treatment. CNS Spectr. 2012; 17 (Suppl 1): 1021.Google Scholar
Ritsner, MS, ed. Polypharmacy in Psychiatric Practice, Volume I: Multiple Medication Use Strategies. New York: Springer Verlag; 2013.Google Scholar
Ritsner, MS, ed. Polypharmacy in Psychiatric Practice, Volume II: Use of Polypharmacy in the "Real World". New York: Springer Verlag; 2013.Google Scholar
Stentebjerg-Olesen, M, Jeppesen, P, Pagsberg, AK, et al. Early nonresponse determined by the Clinical Global Impressions scale predicts poorer outcomes in youth with schizophrenia spectrum disorders naturalistically treated with second-generation antipsychotics. J. Child Adolesc. Psychopharmacol. 2013; 23(10): 665675.Google Scholar
Mauri, MC, Volonteri, LS, Colasanti, A, et al. Clinical pharmacokinetics of atypical antipsychotics: a critical review of the relationship between plasma concentrations and clinical response. Clin. Pharmacokinet. 2007; 46(5): 359388.Google Scholar
Remington, G, Kapur, S. Antipsychotic dosing: how much but also how often? Schizophr. Bull. 2010; 36(5): 900903.Google Scholar
Samaha, AN, Seeman, P, Stewart, J, Rajabi, H, Kapur, S. “Breakthrough” dopamine supersensitivity during ongoing antipsychotic treatment leads to treatment failure over time. J. Neurosci. 2007; 27(11): 29792986.CrossRefGoogle ScholarPubMed
Seeman, P. Dopamine D2 receptors as treatment targets in schizophrenia. Clin. Schizophr. Relat. Psychoses. 2010; 4(1): 5673.Google Scholar
Davis, JM, Chen, N. Dose response and dose equivalence of antipsychotics. J. Clin. Psychopharmacol. 2004; 24(2): 192208.Google Scholar
Krakowski, MI, Kunz, M, Czobor, P, Volavka, J. Long-term high-dose neuroleptic treatment: who gets it and why? Hosp. Community Psychiatry. 1993; 44(7): 640644.Google Scholar
Gisev, N, Bell, JS, Chen, TF. Factors associated with antipsychotic polypharmacy and high-dose antipsychotics among individuals receiving compulsory treatment in the community. J. Clin. Psychopharmacol. 2014; 34(3): 307312.Google Scholar
Roh, D, Chang, JG, Kim, CH, et al. Antipsychotic polypharmacy and high-dose prescription in schizophrenia: a 5-year comparison. Aust. N. Z. J. Psychiatry. 2014; 48(1): 5260.Google Scholar
Barnes, TR, Paton, C. Antipsychotic polypharmacy in schizophrenia: benefits and risks. CNS Drugs. 2011; 25(5): 383399.Google Scholar
Fleischhacker, WW, Uchida, H. Critical review of antipsychotic polypharmacy in the treatment of schizophrenia. Int. J. Neuropsychopharmacol. 2014; 17(7): 10831093.Google Scholar
Fujita, J, Nishida, A, Sakata, M, Noda, T, Ito, H. Excessive dosing and polypharmacy of antipsychotics caused by prorenata in agitated patients with schizophrenia. Psychiatry Clin. Neurosci. 2013; 67(5): 345351.Google Scholar
Gallego, JA, Bonetti, J, Zhang, J, Kane, JM, Correll, CU. Prevalence and correlates of antipsychotic polypharmacy: a systematic review and meta-regression of global and regional trends from the 1970s to 2009. Schizophr. Res. 2012; 138(1): 1828.Google Scholar
Lochmann van Bennekom, MWH, Gijsman, HJ, Zitman, FG. Antipsychotic polypharmacy in psychotic disorders: a critical review of neurobiology, efficacy, tolerability and cost effectiveness. J. Psychopharmacol. 2013; 27(4): 327336.Google Scholar
Sagud, M, Vuksan-Cusa, B, Zivkovic, M, et al. Antipsychotics: to combine or not to combine? Psychiatr. Danub. 2013; 25(3): 306310.Google ScholarPubMed
Suokas, JT, Suvisaari, JM, Haukka, J, Korhonen, P, Tiihonen, J. Description of long-term polypharmacy among schizophrenia outpatients. Soc. Psychiatry Psychiatr. Epidemiol. 2013; 48(4): 631638.Google Scholar
Freudenreich, O, Goff, DC. Antipsychotic combination therapy in schizophrenia: a review of efficacy and risks of current combinations. Acta Psychiatr. Scand. 2002; 106(5): 323330.Google Scholar
Goren, JL, Meterko, M, Williams, S, et al. Antipsychotic prescribing pathways, polypharmacy, and clozapine use in treatment of schizophrenia. Psychiatr. Serv. 2013; 64(6): 527533.Google Scholar
Englisch, S, Zink, M. Treatment-resistant schizophrenia: evidence-based strategies. Mens Sana Monogr. 2012; 10(1): 2032.Google Scholar
Langle, G, Steinert, T, Weiser, P, et al. Effects of polypharmacy on outcome in patients with schizophrenia in routine psychiatric treatment. Acta Psychiatr. Scand. 2012; 125(5): 372381.CrossRefGoogle ScholarPubMed
Essock, SM, Schooler, NR, Stroup, TS, et al. Effectiveness of switching from antipsychotic polypharmacy to monotherapy. Am. J. Psychiatry. 2011; 168(7): 702708.Google Scholar
Stahl, SM, Grady, MM. A critical review of atypical antipsychotic utilization: comparing monotherapy with polypharmacy and augmentation. Curr. Med. Chem. 2004; 11(3): 313327.Google Scholar
Stahl, SM. Focus on antipsychotic polypharmacy: evidence-based prescribing or prescribing-based evidence? Int. J. Neuropsychopharmacol. 2004; 7(2): 113116.Google Scholar
Stahl, SM. Antipsychotic polypharmacy: evidence based or eminence based? Acta Psychiatr. Scand. 2002; 106(5): 321322.Google Scholar
Stahl, SM. Antipsychotic polypharmacy: squandering precious resources? J. Clin. Psychiatry. 2002; 63(2): 9394.Google Scholar
Stahl, SM. Antipsychotic polypharmacy, part 2: tips on use and misuse. J. Clin. Psychiatry. 1999; 60(8): 506507.Google Scholar
Stahl, SM. Antipsychotic polypharmacy, part 1: therapeutic option or dirty little secret? J. Clin. Psychiatry. 1999; 60(7): 425426.Google Scholar
Stahl, SM. “Awakening” from schizophrenia: intramolecular polypharmacy and the atypical antipsychotics. J. Clin. Psychiatry. 1997; 58(9): 381382.Google Scholar
Suzuki, T, Uchida, H, Tanaka, KF, et al. Revising polypharmacy to a single antipsychotic regimen for patients with chronic schizophrenia. Int. J. Neuropsychopharmacol. 2004; 7(2): 133142.CrossRefGoogle ScholarPubMed
Correll, CU, Rummel-Kluge, C, Corves, C, Kane, JM, Leucht, S. Antipsychotic combinations vs monotherapy in schizophrenia: a meta-analysis of randomized controlled trials. Schizophr. Bull. 2009; 35(2): 443457.Google Scholar
Iasevoli, F, Buonaguro, EF, Marconi, M, et al. Efficacy and clinical determinants of antipsychotic polypharmacy in psychotic patients experiencing an acute relapse and admitted to hospital stay: results from a cross-sectional and a subsequent longitudinal pilot study. ISRN Pharmacology. 2014; 2014: 762127.Google Scholar
Coccaro, EF. Intermittent explosive disorder as a disorder of impulsive aggression for DSM-5. Am. J. Psychiatry. 2012; 169(6): 577588.Google Scholar
Rosell, DR, Thompson, JL, Slifstein, M, et al. Increased serotonin 2A receptor availability in the orbitofrontal cortex of physically aggressive personality disordered patients. Biol. Psychiatry. 2010; 67(12): 11541162.Google Scholar
Winstanley, CA, Theobald, DE, Dalley, JW, Glennon, JC, Robbins, TW. 5-HT2A and 5-HT2C receptor antagonists have opposing effects on a measure of impulsivity: interactions with global 5-HT depletion. Psychopharmacology (Berl.). 2004; 176(3–4): 376385.Google Scholar
Englisch, S, Zink, M. Combined antipsychotic treatment involving clozapine and aripiprazole. Prog. Neuropsychopharmacol. Biol. Psychiatry. 2008; 32(6): 13861392.CrossRefGoogle ScholarPubMed
Katona, L, Czobor, P. Bitter I. Real-world effectiveness of antipsychotic monotherapy vs. polypharmacy in schizophrenia: to switch or to combine? A nationwide study in Hungary. Schizophr. Res. 2014; 152(1): 246254.Google Scholar
Ballon, J, Stroup, TS. Polypharmacy for schizophrenia. Curr. Opin. Psychiatry. 2013; 26(2): 208213.Google Scholar
Fleischhacker, WW, Heikkinen, ME, Olie, JP, et al. Effects of adjunctive treatment with aripiprazole on body weight and clinical efficacy in schizophrenia patients treated with clozapine: a randomized, double-blind, placebo-controlled trial. Int. J. Neuropsychopharmacol. 2010; 13(8): 11151125.Google Scholar
Chang, JS, Ahn, YM, Park, HJ, et al. Aripiprazole augmentation in clozapine-treated patients with refractory schizophrenia: an 8-week, randomized, double-blind, placebo-controlled trial. J. Clin. Psychiatry. 2008; 69(5): 720731.Google Scholar
Thompson, C. The use of high-dose antipsychotic medication. Br. J. Psychiatry. 1994; 164(4): 448458.Google Scholar
Schwartz, TL, Stahl, SM. Treatment strategies for dosing the second generation antipsychotics. CNS Neurosci. Ther. 2011; 17(2): 110117.Google Scholar
Volavka, J, Czobor, P, Nolan, K, et al. Overt aggression and psychotic symptoms in patients with schizophrenia treated with clozapine, olanzapine, risperidone, or haloperidol. J. Clin. Psychopharmacol. 2004; 24(2): 225228.CrossRefGoogle ScholarPubMed
Kantrowitz, JT, Citrome, L. Lurasidone for schizophrenia: what's different? Expert Rev. Neurother. 2012; 12(3): 265273.Google Scholar
Aggarwal, NK, Sernyak, MJ, Rosenheck, RA. Prevalence of concomitant oral antipsychotic drug use among patients treated with long-acting, intramuscular, antipsychotic medications. J. Clin. Psychopharmacol. 2012; 32(3): 323328.CrossRefGoogle ScholarPubMed
Elie, D, Poirier, M, Chianetta, J, et al. Cognitive effects of antipsychotic dosage and polypharmacy: a study with the BACS in patients with schizophrenia and schizoaffective disorder. J. Psychopharmacol. 2010; 24(7): 10371044.Google Scholar
Hiemke, C, Baumann, P, Bergemann, N, et al. AGNP consensus guidelines for therapeutic drug monitoring in psychiatry: update 2011. Pharmacopsychiatry. 2011; 44(6): 195235.Google ScholarPubMed
Potkin, SG, Keator, DB, Kesler-West, ML, et al. D2 receptor occupancy following lurasidone treatment in patients with schizophrenia or schizoaffective disorder. CNS Spectr. 2014; 19(2): 176181.Google Scholar

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